Abstract
Background
Follow-up computed tomography angiography (CTA) scans add considerable postimplantation
costs to endovascular aneurysm repairs (EVARs) of abdominal aortic aneurysms (AAAs).
By building a risk model, we hope to identify patients at low risk for aneurysm sac
enlargement to minimize unnecessary CTAs.
Methods
895 consecutive patients who underwent EVAR for AAA were reviewed, of which 556 met
inclusion criteria. A Probit model was created for aneurysm sac enlargement, with
preoperative aneurysm morphology, patient demographics, and operative details as variables.
Results
Our final model included 287 patients and had a sensitivity of 100%, a specificity
of 68.9%, and an accuracy of 70.4%. Ninety-nine (35%) of patients were assigned to
the high-risk group, whereas 188 (65%) of patients were assigned to the low-risk group.
Notably, regarding anatomic variables, our model reported that age, pulmonary comorbidities,
aortic neck diameter, iliac artery length, and aneurysms were independent predictors
of post-EVAR sac enlargement. With the exception of age, all statistically significant
variables were qualitatively supported by prior literature. With regards to secondary
outcomes, the high-risk group had significantly higher proportions of AAA-related
deaths (5.1% versus 1.1%, P = 0.037) and Type 1 endoleaks (9.1% versus 3.2%, P = 0.033).
Conclusions
Our model is a decent predictor of patients at low risk for post AAA EVAR aneurysm
sac enlargement and associated complications. With additional validation and refinement,
it could be applied to practices to cut down on the overall need for postimplantation
CTA.
Keywords
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Article info
Publication history
Published online: December 27, 2016
Accepted:
December 21,
2016
Received in revised form:
November 30,
2016
Received:
December 4,
2015
Identification
Copyright
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